Mary Michelle Malkin, PHARMD

Primary specialty

PharmacistTaxonomy code 183500000X

License

065666-01 Issued in NY

Practice address

5410 Fredericksburg Rd Ste 304
San Antonio, TX 78229-3576

Phone

(210) 352-5175

NPI assigned

Nov 9, 2021

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Innovative Genomics LLC

  • Clinical Medical Laboratory
  • San Antonio, TX
  • NPI 1629531769
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1636416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636416000000",
    "number": "1689330144",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9940 63RD RD APT 11L",
            "city": "REGO PARK",
            "state": "NY",
            "postal_code": "113741953",
            "telephone_number": "347-229-6400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5410 FREDERICKSBURG RD STE 304",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782293576",
            "telephone_number": "210-352-5175"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALKIN",
        "first_name": "MARY",
        "middle_name": "MICHELLE",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-11-09",
        "last_updated": "2021-11-09",
        "certification_date": "2021-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NJ",
            "license": "28RI04075700",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NY",
            "license": "065666-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Samira Malik, PH.D.
• Shahvaizumar Malik
• Shazli Noorali Malik, M.D.
• Isaac Malit
• Ratna Melanie Malkan, DO
• Trishangi Malla
• Amapola Imbag Mallari, PHYSICAL THERAPIST
• Steven Charles Maller, D.D.S., M.S.
• Mallernee Family Dental PLLC
• Kye Edward Mallernee, D.M.D.

• Pharmacist in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Pharmacist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.